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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: GE MEDICAL SYSTEMS, LLC CT750 HD; COMPUTED TOMOGRAPHY X-RAY SYSTEM

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GE MEDICAL SYSTEMS, LLC CT750 HD; COMPUTED TOMOGRAPHY X-RAY SYSTEM Back to Search Results
Model Number CSPH03
Device Problem Adverse Event Without Identified Device or Use Problem (2993)
Patient Problem Limb Fracture (4518)
Event Type  Injury  
Manufacturer Narrative
Unique identifier: udi not required.Legal manufacturer: (b)(6).Ge healthcare's investigation is ongoing.A follow up report will be submitted when the investigation has been completed.Device evaluation anticipated, but not yet begun.
 
Event Description
It was reported that a patient penetrated the scan window during a ct scan; sustaining a broken arm.
 
Manufacturer Narrative
The root cause was determined to be unintended user error, i.E.The operator did not properly position and strap the patient securely for the procedure.The user manual provides instructions on appropriate patient positioning.
 
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Brand Name
CT750 HD
Type of Device
COMPUTED TOMOGRAPHY X-RAY SYSTEM
Manufacturer (Section D)
GE MEDICAL SYSTEMS, LLC
3000 n grandview blvd.
waukesha, WI 53188
Manufacturer (Section G)
GE MEDICAL SYSTEMS, LLC
3000 n grandview blvd.
waukesha, WI 53188
Manufacturer Contact
susan strasser
3000 n grandview blvd
waukesha, WI 53188
MDR Report Key12418195
MDR Text Key270283277
Report Number2126677-2021-00046
Device Sequence Number1
Product Code JAK
Combination Product (y/n)N
Reporter Country CodeCH
PMA/PMN Number
K081105
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Foreign,Health Professional,User Facility
Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup
Report Date 11/10/2021
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received09/02/2021
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? No
Device Operator Health Professional
Device Model NumberCSPH03
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Date Manufacturer Received10/12/2021
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured04/20/2012
Is the Device Single Use? No
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage A
Patient Sequence Number1
Patient Age70 YR
Patient SexMale
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